Expression of the substance P precursor preprotachykinin A defines a distinct population of superficial dorsal horn excitatory neurons, many of which respond to noxious or pruritic stimuli.
Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) are highly comorbid and share executive function and emotion processing deficits, complicating diagnoses despite distinct clinical features. We compared performance on an oculomotor task that assessed these processes to capture subtle differences between ADHD and BD. The interaction between emotion processing and executive functioning may be informative because, although these processes overlap anatomically, certain regions that are compromised in each network are different in ADHD and BD. Adults, aged 18-62, with ADHD (n = 22), BD (n = 20), and healthy controls (n = 21) performed an interleaved pro- and antisaccade task (looking toward vs. looking away from a visual target, respectively). Task irrelevant emotional faces (fear, happy, sad, neutral) were presented on a subset of trials either before or with the target. The ADHD group made more direction errors (looked in the wrong direction) than controls. Presentation of negatively valenced (fear, sad) and ambiguous (neutral) emotional faces increased saccadic reaction time in BD only compared to controls, whereas longer presentation of sad faces modestly increased group differences. The antisaccade task differentiated ADHD from controls. Emotional processing further impaired processing speed in BD. We propose that the dorsolateral prefrontal cortex is critical in both processing systems, but the inhibitory signal this region generates is impacted by dysfunction in the emotion processing network, possibly at the orbitofrontal cortex, in BD. These results suggest there are differences in how emotion processing and executive functioning interact, which could be utilized to improve diagnostic specificity. (PsycINFO Database Record
In a psychiatric inpatient sample, patients with bipolar disorder and ADHD were not more severely ill in the acute phase and did not have a poorer outcome at 8 weeks.
Zusammenfassung: Hauptsymptom der affektiven Erkrankungen ist eine Veränderung der Stimmung. Inwieweit die Stimmungsstörung mit einer emotionalen Dysregulation einhergeht, wird aber erst in den letzten Jahren vermehrt untersucht. Der vorliegende Beitrag gibt einen Überblick über den Stand der aktuellen Forschung in Bezug auf die Frage, inwieweit und welche Emotionsregulationsstrategien bei Patienten mit einer unipolaren Depression oder einer bipolaren affektiven Störung in der akuten Episode verändert sind, also als zustandsabhängige Veränderungen anzusehen sind. Desweiteren wird erörtert, inwieweit es sich bei den Veränderungen der Regulationsstrategien, wie z. B. Unterdrückung oder Neubewertung, um Vulnerabilitätsfaktoren für depressive Störungen handelt. Kognitive Reaktivität wird ebenfalls als Vulnerabilitätsfaktor beschrieben. Der Beitrag führt in das Konzept ein und arbeitet die Verbindung zur psychologischen Forschung der Affektivregulation als Vulnerabilitätsfaktor depressiver Störungen heraus. Neuere psychotherapeutische Ansätze, die sich auf Emotionsregulationsstrategien beziehen, werden kurz dargestellt. Der Beitrag schließt mit einem Ausblick.
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